Montreal advocates hope to tackle TB by helping Inuit train as health care aides

See Change Initiative, a non-profit in Montreal, and Ilisaqsivik Society in Clyde River, Nunavut, want to focus on a “bottom-up” approach to tackle the TB crisis in the north by putting Inuit communities at the heart of the project.

See Change Initiative wants to see shift to 'bottom-up' community-based model of care

Madlen Nash and Rachel Kiddell-Monroe hope See Change Initiative will support Inuit in Nunavut to empower them with the skills and knowledge for health care delivery. (Jessica Deer/CBC)

The high rates of tuberculosis in Nunavut is something two Montreal women were ashamed to only recently learn about, despite their years of global work combating the infectious disease.

"We couldn't just sit at home and do nothing," said Rachel Kiddell-Monroe, general director of the non-profit See Change Initiative. 

She has years of experience working with Médecins Sans Frontières, while Madlen Nash has worked abroad on TB in India and South Africa for the past three years. Together, they launched the non-profit, which had its first fundraising event in Montreal on Thursday. 

"We're ashamed as Canadians that this is happening in our own country and feel that there is something we can do to contribute to ending TB in the north forever, and also contributing to reducing other health inequities that exist between Indigenous and non-Indigenous Canadians," said Nash.

According to a report released earlier this year from the Public Health Agency of Canada, TB rates are almost 300 times higher among Inuit than for the non-Indigenous Canadian-born population.

Taking the 'bottom up' approach

The two women hope that number will drastically go down in the coming years with a partnership with Ilisaqsivik Society in Clyde River, Nunavut, to develop a "bottom-up" approach to tackle the TB crisis.

Joavee Etuangat is the chairman of the board of directors at Ilisaqsivik and knows first hand the impacts of TB on his community. His mother died in a building where TB patients were held.  

"TB cases were an epidemic in our area at one point and it was eradicated but now it seems to be coming back. It is very important that we know what TB is and how to prevent it," he said in Inuktitut via video message to attendees at the fundraiser.

Annie Ittoshat, an Inuk community minister of the Diocese of the Arctic, opened Thursday’s launch with a prayer. (Jessica Deer/CBC)

The goal is to create a community public health aide training lab to support prevention, diagnosis and treatment of TB through a task-sharing model that seeks to empower community members to take ownership over the delivery of health care.

"The critical point of it is that the communities are at the heart of it," said Nash.

"To merge southern knowledge with Inuit traditional knowledge and ways of learning, trying to create a program that is completely run in Inuktitut and run by Inuit."

An exciting shift

Shifting from a 'top down' model of care that relies heavily on nurses from the south to a 'bottom-up' community-based model of care is something exciting for Ilisaqsivik executive director Malcolm Ranta.

"Communities in Nunavut are traditionally staffed by nurses form the south. There's lots of turnover, gaps and vacancies that makes it difficult for continuity of care," he said.

"Having a model that can train and empower community members to be involved in the health-care system and the delivery of health is going to be a huge benefit. We look forward to moving forward with the project and seeing those benefits."

About the Author

Jessica Deer


Jessica Deer is Kanien’kehá:ka from Kahnawake. A former staff reporter for the Eastern Door, she works in CBC's Indigenous unit based in Montreal. Email her at or follow her on Twitter @Kanhehsiio.